A Study of the Potentially Harmful Pathogens on Environmental Surfaces in Healthcare Facilities in Edo State, Nigeria.

Introduction: Inadvertent exposure to environmental and airborne pathogens can result in adverse patient outcomes and transmission of hospital acquired infections (HAIs) in healthcare workers (HCWs). Without effective infection control, diseases may be readily transmitted from patient to patient and to a lesser extent, from patient to HCWs.Objective:  To determine potential pathogens present on environmental surfaces in secondary and tertiary healthcare facilities (HCFs) in Edo State, Nigeria.Method:  Environmental sampling and analysis was done to determine presence of potential pathogens in nine (9) health facilities. Sterile swabs were used to collect surface samples from non-absorbent surfaces in the health facilities. A total of 324 samples were analyzed. All the isolates were tested for their susceptibility to the various common antimicrobial agents using the standard agar disk diffusion technique. The antimicrobial agents used in this study were gentamycin, nalidixic acid, nitrofurantoin, ampicilin, co-trimoxazole, cefuroxine, ceftazidine, augmentin, ciprofloxacin, ofloxacin and ceftriaxone.Results:  Potentially harmful pathogens namely Staphylococcus aureus, Streptococcus spp, Proteus spp, Escherichia coli and Klebsiella spp were identified in the samples from the health facilities and these were resistant to antibiotics which are commonly prescribed and in the national essential drug list.Conclusion:  The study revealed presence of potentially pathogenic microorganisms on the physical surfaces of secondary and tertiary healthcare facilities in Edo State, Nigeria. Health facilities need to develop and implement infection prevention and control programmes for the protection of patients, patient care givers and healthcar

Assessment of the role of traditional birth attendants in maternal health care in Oredo Local Government Area, Edo State, Nigeria

Background: Since the adoption of the Primary Health Care (PHC) approach in Nigeria in 1979, government has recognized the need for integrating traditional birth attendants (TBAs) into the PHC system and had consequently initiated TBAs training programmes. In spite of the high patronage of traditional birth attendants, many of their practices during childbirth have been found to adversely affect the health of mothers. This study aimed at assessing the role of TBAs in maternal health in Oredo Local Government, Benin City, Edo-State, Nigeria. Methodology: All the TBAs identified through snowball method within the LGA consented to providing information, through interviewer-administered questionnaires on their reproductive health practices. Results: Of the 45 TBAs interviewed, forty-four (97.8%) were female. The majority (62.2%) acquired their skills through apprenticeship with relation, while 8.9% had no training at all. The services provided by the TBAs ranged from ante-natal care provided by 53.3%, child delivery, 97.8%, treatment of infertility, 60.0%, management of threatened abortion, 13.3% and circumcision of babies, 28.9%. Preparations used in the treatment of cord stump included methylated spirit used by 42.2% of the respondents, herbal preparations, 28.9%, dry heated sand, 11.1% and engine oil, 6.7%. Some of the medications used (animal dung, flies, scarification marks, and cow urine) to treat patients could serve as sources of infection. Methods of risk assessment during ante-natal care, management of delivery complications, record keeping among TBAs were found to be poor. Infection prevention methods used were also found to be poor, with more than half (51.1%) not using any form of preventive measures during procedures. Conclusion: This study has revealed that the practices of these TBAs are not safe. There is need for improvement through a more holistic training programme including monitoring and supervision.Keywords: traditional birth attendants, role, maternal healthJournal of Community Medicine and Primary Health Care 2005, 17(1): 55-6

Knowledge and attitude towards onchocerciasis and community directed treatment with ivermectin in endemic communities in Edo State, Nigeria.

Objective: Community directed treatment with ivermectin (CDTI) was developed as a solution for the control and elimination of onchocerciasisis. It involves active and structural community participation. CDTI requires that ivermectin be administered continuously over a period of at least 14years before elimination can be achieved in hyper and meso-endemic communities. The study assessed the knowledge and attitude of community's members towards onchocerciasis and the CDTI strategy in endemic communities in Edo State, Nigeria.Methods: This was a descriptive cross-sectional study involving seven hundred and twenty community members' selected using multistage sampling technique. Data was collected using a pre-tested structured interviewers' administered questionnaire and was analysed using IBM SPSS version 21.0 software. Level of statistical significance was set at p < 0.05Results: The mean age (SD) of respondents was 45.9 (15.2) years. Six hundred and one (83.5%) and 591 (82.1%) of the respondents had good knowledge of onchocerciasis and CDTI strategy respectively. The significant predictors of good knowledge on onchocerciasis were age (p = 0.001), sex (p = 0.001) and level of education (p = 0.001) while that of CDTI strategy were sex (p = 0.001) and level of education (p = 0.001). Five hundred and ninety seven (82.9%) of the respondents had a good attitude towards the CDTI strategy and its significant predictor was level of education (p = 0.006)Conclusion: Findings from this study revealed that there are still gaps in knowledge as regards onchocerciasis and the CDTI strategy among community members in the study area. Re-enforcement of health education messages on onchocerciasis and CDTI strategy in endemic areas is recommended so as to improve knowledge and consequent acceptance of the CDTI strategy.Keywords: Community Directed Treatment with Ivermectin, Onchocerciasis. Knowledge, Attitude, Nigeria

Incidence of blood-related work accidents among health workers in a government hospital in Benin City, Nigeria

Accidents are hazards to which health workers are exposed. Hazards may be physical, chemical, biological, mechanical or psychosocial. Mechanical hazards are very common in the health industry because of the frequent use of pointed and sharp instruments such as needles, scalpel and knives. This six-month (June 1999 and June 2000) longitudinal incidence study was carried out at the Central Hospital, Benin City, Nigeria, as a follow-up on a previous cross-sectional study on frequency of blood-related work accidents in the same hospital. All the doctors, laboratory workers and 50% of nurses were included in the study. The nurses were selected using stratified random sampling method. Two hundred and fourteen health care workers started the follow-up study, out of which 146 were left at the end of the six-month period, giving an attrition rate of 31.8%. Results shows that contact with patients' blood with ungloved hands, blood splashes on the face and other parts of the body, needle pricks, cuts from drug ampoules and glove perforation during surgery were the major work-related accidents/injuries during the six-month follow-up. This is similar to findings from the retrospective study. The frequencies of various accidents were higher during the six-month follow-up (incidence study) than the six months prior to the study (retrospective study). Combining all the health workers, the incidence densities of these five major work-related accidents were between 3.6 per person years (ppy) to 9.5ppy. These incidence densities were all significantly higher for doctors than nurses or laboratory workers. There is an urgent need to reduce the incidence of these work-related accidents/injuries in order to reduce the chances of health workers developing occupationally acquired diseases

Exploring the Impact of COVID-19 on Communities and the Mitigation Efforts

Background: The Coronavirus disease 2019 caused by the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has triggered a pandemic of a proportion that was only seen over a century ago when the Spanish flu ravaged the world in 1918. The focus of this review was to explore the impact of COVID-19 on communities and the mitigation efforts.Discussion: The COVID-19 pandemic has triggered an enormous impact on various communities; including geographical, working, those who have fled conflict areas and academic/research communities with a global surge in the demand for health and social services. There are also some positive impacts such as the boom in research output and global collaboration while bringing to the fore the very important role of public health and community medicine specialty.Conclusion: The COVID-19 pandemic has exposed the enormous deficiencies in health systems including the social and welfare support of various communities. There is need to sustain mitigation efforts that have been instituted and prepare for future pandemics as connected cycles while learning from the past ones. Keywords: Communities; COVID-19; Impact; Mitigation; SARS-CoV-

Knowledge, attitude and practices of adolescent secondary school students in Uvwie Local Government Area of Delta State of HIV/AIDS.

INTRODUCTION: Adolescents have a tendency to engage in high risk sexual and drug-use behaviour; and with a poor health-seeking behaviour, they continue to present the highest number of new cases of HIV reported in Africa. OBJECTIVE: To assess the knowledge, attitude and practise of adolescent secondary school students towards AIDS. METHOD: A cross sectional study was carried out on 358 senior secondary students selected by multistage sampling. A researcher administered semi-structured questionnaire was used for data collection. RESULTS: All had heard of AIDS, of which 40% cited the media as source of information. Seventy four percent knew the cause to be a virus, 63% could differentiate between AIDS and HIV, over 85% knew of transmission through sex, mother to child, contaminated blood, and contaminated needles; 59% cited kissing. Weight loss was the most common symptom (85%) mentioned. Over 76% knew AIDS to be untreatable. Over 75% knew methods to prevent spread of which 23% cited sex with a virgin, 61% did not know anyone infected with the virus, 58% felt infected persons should not be allowed to stay in the community, 61 % agreed to continue a relationship with an infected friend, 83% agreed to care for an infected relative. Of 22% who agreed they were sexually active, 66% and 12% had one and multiple partners respectively. Regarding protection, 30% used condom always, 48 % sometimes and 23 % never. Twenty-one percent had ever had sex under influence of alcohol or marijuana. 55% were willing to be tested, however none had been tested. CONCLUSION: Senior secondary school students in Uvwie have a fairly good knowledge of AIDS, and poor attitude towards people living with AIDS. Few are sexually active and are engaged in unsafe sex. KEYWORDS: AIDS, secondary school students, condom use, knowledge, HIV risk behaviour, sexual practices

Attitude and practice of health care workers in a tertiary health facility towards voluntary counselling and testing for HIV

Context: Nigeria is right now battling with the epidemic of HIV/AIDS with a median prevalence of 5.0%. Voluntary counselling and testing (VCT) is being advocated so that people can know their HIV status and modify their behaviour appropriately. Health workers are at risk of contracting and spreading the HIV infection and it would therefore be needful for them to know their status and they also are in a vantage position to promote and encourage VCT. This study was therefore designed to assess their attitude and practice towards this strategy. Methodology: A cross-sectional descriptive study was conducted among health workers in the University of Benin Teaching Hospital, a tertiary health institution in Benin City, Edo State between October 2002 and April 2003 using a stratified random sampling method in selecting respondents. Information was obtained through the use of self-administered questionnaire. Results: A total of 242 health workers made up of 48.8% doctors, 33.1% nurses, 11.2% laboratory scientists and 6.9% pharmacists were involved in the study. Mean age of respondents was 35.8 + 8.7 years. One hundred and seventy four (71.9%) had actually been screened for HIV. Eighty-two (47.1%) of these did so voluntarily while it was mandatory for 92 (52.9%) others. A total of 227 (93.8%) appreciated the importance of knowing one's HIV status observing that it will enable them take precautions (52.1%) and enable them commence treatment early, (19.4%). Conclusion: Since VCT for HIV is an important component of HIV prevention and care, it should be promoted in health care settings. KEY WORDS: Voluntary counselling and testing; Attitudes; Practice; Health care workers Journal of Community Medicine & Primary Health Care Vol.16(2) 2004: 39-4

Knowledge of HIV/AIDS and Sexual Practi- ces among Adolescents in Benin City, Nigeria

A cross sectional study to determine the knowledge of HIV/AIDS and sexual practices of adolescents was undertaken in Benin City, Nigeria. Benin City the capital of Edo State, Nigeria, has 40 government owned secondary schools comprising 6 boys, 10 girls, and 24 mixed. Out of these 3 schools were randomly selected for survey viz; Adolor (boys only), Iyoba (girls only), Army Day (mixed). The sample size for the survey was 920 while the total population for selected schools was 1692 giving a sampling ratio of 1:2. Using the systematic sampling method and class register as sampling frame every other child was selected for the study. However, only 852 students consented to participate giving a response rate of 92.6%. An overwhelming majority of the adolescents were aware of HIV/AIDS but only 16.2% knew the cause of the disease. The submission that kissing, living with infected persons and sharing their utensils could lead to infection was an indication of ignorance. Sexual intercourse was the predominant route of transmission mentioned by 60.0% while multiple sexual partners was prevalent among age group 13-15 years. Playing with sharps, frequent clean head shave with unsterilised instruments in the barbing saloon and promiscuity were some of the activities that adolescents were involved in that could lead to HIV/AIDS infection. In conclusion, the knowledge of the study population was poor and correlates with their reckless sexual practices. Prevention is the best option to the disease. Better informed youths on HIV/AIDS will enhance the principle of prevention.La connaissance du VIH/SIDA et les pratiques sexuelles chez les adolescents à Benin-City, Nigéria Arrière Plan: VIH/SIDA est une maladie sexuellement transmissible. La maladie a un taux de mortalité élévé et la fatalité la plus élévée est subie par les Africains. Les traditions culturelles, les croyances, la peur et les autres inhibitions ont empêché les enfants de cette région d'acquérir la connaissance au sujet du sexe et des maladies sexuellement transmissibles de la part de leur parents et leurs enseignants tandis qu'ils ont un grand désir de s'explorer, se rendant ainsi vulnérables à l'infection. Objectifs: L'objectif de l'enquête était de découvrir combien ce groupe vulnérable connaît du VIH/SIDA par rapport à leurs pratiques sexuelles. Méthode: Une étude transversale a été enterprise pour déterminer la connaissance chez les adolescents du VIH/SIDA et des pratiques sexuelles à Benin _ City, Nigéria. Benin-City, qui est la capitable de l'Etat d'Edo possède 40 écoles secondaires gouvernementales. Parmi ces écoles, troîs ont été selectionnées pour l'enquête à savoir Adolor (pour garcons), Iyoba (pour filles) et Army Day (mixte). La population totale de toutes les écoles selectionnées était de 1692, tandis que la taille d'échantillon était 920. On s'est servi de la méthode de l'échantillon systématique pour selectionner 920 sujets mais seuls 852 ont accepté de participer, ce qui a donné un taux de réponse de 92,6%. Découvertes importantes: Une majorité écrasante de la population étaient au courant du VIH/SIDA mais seuls 16,2% connaissaient la cause de la maladie. L'argument que le fait d'embrasser quelqu'un, de vivre avec quelqu'un qui est infecté et de partager leurs ustensils pourrait conduire à l'infection était une indication de l'ignorance. L'acte sexuel était la route de transmission la plus dominante indiquée par 60,0%, alors que les partenaires sexuels prévalent chez le groupe d'âge 13 _ 15 ans. Jouer avec des objets aigus, se faire bien raser à l'aide des instruments non stérilisés chez le coiffeur aussi bien que la promiscuité étaient parmi les activités dans lesquelles les édudiants sont engagés qui pourraient conduire à l'infection du VIH/SIDA.Conclusion: La connaissance de la population étudiée concernant l'étiologie du HIH/SIDA était d'un bas niveau et est en corrélation avec leurs pratiques sexuellels insouciantes. La prévention est la meilleure option pour la maladie. Une jeunesse mieux renseignée sur le VIH/SIDA mettra en valeur le principle de la prévention

Premarital sex and condom use among trainee healthcare workers: an exploratory study of selected healthcare training institutions in Enugu State, Nigeria

Introduction: to assess the prevalence and causes of premarital sex and condom use among trainee healthcare workers in selected healthcare institutions in Enugu State, Nigeria; and to proffer solution to challenges identified. Methods: we used a mixed study approach with qualitative and quantitative components. Informed consent was obtained from participants and data collected using self-administered structured questionnaires. Epi info® was used for data analysis. Results: a total of 362 respondents (309 unmarried) from four healthcare training institutions participated in the study. Among unmarried respondents, 141(45.8%) were sexually active. Premarital sex was more common among Pentecostals and sexual activity increased with age (r=0.78; p <0.05). Premarital sexual activity was more common among males and trainee nurses (p <0.005). Although knowledge of condom use was high, actual use was poor (20.1%), with lowest rates among females, Catholics and age-group 30-35 years. Breakages, high failure rates and reduced sexual satisfaction were cited as major factors responsible for poor use. Use of non-specific terms such as "casual sex" and "casual or regular sex partners" hindered consistent, correct condom use. Conclusion: there is a significant gap between knowledge of and actual use of condoms, despite high premarital sexual activity amongst healthcare workers. Furthermore, non-specific terminologies hinders appropriate condom usage. We propose the term: Committed Spousal Partner (CSP) defined as "a sexual partner who commits to fidelity (one sexual partner per time) and whose current HIV status is known through medical testing and is properly documented" in place of all non-specific terminology